• Plos One · Jan 2017

    Low cholesterol level associated with severity and outcome of spontaneous intracerebral hemorrhage: Results from Taiwan Stroke Registry.

    • Yu-Wei Chen, Chen-Hua Li, Chih-Dong Yang, Chung-Hsiang Liu, Chih-Hung Chen, Jau-Jiuan Sheu, Shinn-Kuang Lin, An-Chih Chen, Ping-Kun Chen, Po-Lin Chen, Chung-Hsin Yeh, Jiunn-Rong Chen, Yu-Jen Hsiao, Ching-Huang Lin, Shih-Pin Hsu, Tsang-Shan Chen, Sheng-Feng Sung, Shih-Chieh Yu, Chih-Hsin Muo, Chi Pang Wen, Fung-Chang Sung, Jiann-Shing Jeng, Chung Y Hsu, and Taiwan Stroke Registry Investigators.
    • Department of Neurology, Taiwan Landseed Hospital, Taoyuan, Taiwan.
    • Plos One. 2017 Jan 1; 12 (4): e0171379.

    AbstractThe relationship between cholesterol level and hemorrhagic stroke is inconclusive. We hypothesized that low cholesterol levels may have association with intracerebral hemorrhage (ICH) severity at admission and 3-month outcomes. This study used data obtained from a multi-center stroke registry program in Taiwan. We categorized acute spontaneous ICH patients, based on their baseline levels of total cholesterol (TC) measured at admission, into 3 groups with <160, 160-200 and >200 mg/dL of TC. We evaluated risk of having initial stroke severity, with National Institutes of Health Stroke Scale (NIHSS) >15 and unfavorable outcomes (modified Rankin Scale [mRS] score >2, 3-month mortality) after ICH by the TC group. A total of 2444 ICH patients (mean age 62.5±14.2 years; 64.2% men) were included in this study and 854 (34.9%) of them had baseline TC <160 mg/dL. Patients with TC <160 mg/dL presented more often severe neurological deficit (NIHSS >15), with an adjusted odds ratio [aOR] of 1.80; 95% confidence interval [CI], 1.41-2.30), and 3-month mRS >2 (aOR, 1.41; 95% CI, 1.11-1.78) using patients with TC >200 mg/dL as reference. Those with TC >160 mg/dL and body mass index (BMI) <22 kg/m2 had higher risk of 3-month mortality (aOR 3.94, 95% CI 1.76-8.80). Prior use of lipid-lowering drugs (2.8% of the ICH population) was not associated with initial severity and 3-month outcomes. A total cholesterol level lower than 160 mg/dL was common in patients with acute ICH and was associated with greater neurological severity on presentation and poor 3-month outcomes, especially with lower BMI.

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